{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T16:45:26Z","timestamp":1788281126597,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,8,14]],"date-time":"2020-08-14T00:00:00Z","timestamp":1597363200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Spontaneous cerebrospinal fluid (CSF) leaks represent a unique subset of skull base pathology and require distinctive management. Perioperative evaluation and management of intracranial hypertension are essential in preventing further erosion of the skull base and development of recurrent leak. The objective of this study is to evaluate the safety and utility of an expedited protocol for recording and managing intracranial hypertension following endoscopic repair of spontaneous CSF leaks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospectively collected data was reviewed in patients undergoing endoscopic repair of spontaneous CSF leaks between January 2017 and March 2020. A standard intracranial pressure monitoring protocol was compared to an expedited protocol (EP), and data regarding the two groups was compared for leak location, short\u2010term success of skull base repair, complications, hospital length of stay, and cost\u2010based analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010five patients (standard protocol, n = 28 vs. EP, n = 27) were included in the study. Leak location was similar between cohorts, with the lateral recess being the most common locations in both groups (37.9% vs. 40.6%; <jats:italic>P<\/jats:italic> =\u2009.90). Postoperative complications (3.6% vs. 7.4%; <jats:italic>P<\/jats:italic> =\u2009.53) and ventriculoperitoneal shunt rate (32.1% vs. 22.2%; <jats:italic>P<\/jats:italic> =\u2009.41) were similar among cohorts. There was no difference in lumbar drain complications (0% vs. 7.4%; <jats:italic>P<\/jats:italic> =\u2009.14) or recurrent leak (7.1% vs. 0%; <jats:italic>P<\/jats:italic> =\u2009.16). Length of stay was shorter in the EP group [median(interquartile range): 3(1) vs. 2 (1); <jats:italic>P<\/jats:italic> &lt;\u2009.01]. Total hospital charges were similar between groups (median (USD\/$1,000): 83.57\u2009\u00b1\u200949.58 vs. 83.93\u2009\u00b1\u200946.11; <jats:italic>P<\/jats:italic> =\u2009.18).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>An expedited monitoring protocol shortened hospital stay without increased risk of complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>III <jats:italic>Laryngoscope<\/jats:italic>, 131:E408\u2013E412, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28929","type":"journal-article","created":{"date-parts":[[2020,8,15]],"date-time":"2020-08-15T06:57:23Z","timestamp":1597474643000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["An Expedited Intracranial Pressure Monitoring Protocol Following Spontaneous <scp>CSF<\/scp> Leak Repair"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6027-4976","authenticated-orcid":false,"given":"Justin P.","family":"McCormick","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Alabama at Birmingham  Birmingham Alabama U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashwini","family":"Tilak","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Alabama at Birmingham  Birmingham Alabama U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Brooks","family":"Lampkin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Alabama at Birmingham  Birmingham Alabama U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7030-6388","authenticated-orcid":false,"given":"Harrison M.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Alabama at Birmingham  Birmingham Alabama U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter L.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Alabama at Birmingham  Birmingham Alabama U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"West","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Alabama at Birmingham  Birmingham Alabama U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Do\u2010Yeon","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Alabama at Birmingham  Birmingham Alabama U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen O.","family":"Riley","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Alabama at Birmingham; Birmingham  Birmingham Alabama U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2131-8005","authenticated-orcid":false,"given":"Jessica W.","family":"Grayson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Alabama at Birmingham  Birmingham Alabama U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3292-9167","authenticated-orcid":false,"given":"Bradford A.","family":"Woodworth","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Alabama at Birmingham  Birmingham Alabama U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,14]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e328011bc76"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2011.06.018"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21262"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812451090"},{"key":"e_1_2_6_6_1","first-page":"92","article-title":"Spontaneous cerebrospinal fluid leak and management of intracranial pressure","volume":"74","author":"Soler ZM","year":"2013","journal-title":"Adv Otorhinolaryngol"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/194589240301700205"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21891"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2014.28.4002"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940611500703"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajr.2008.22.3223"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22399"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26612"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1325636"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814551122"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2012.614"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21019"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2008.12.060"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22245"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22326"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2013.27.3986"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21188"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2016.30.4371"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21810"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816670370"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21023"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2016.30.4377"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2003.12.018"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/194589240301700403"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2010.24.3465"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24160"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.20010"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(98)91234-9"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.28929","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.28929","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.28929","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T08:00:38Z","timestamp":1693641638000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.28929"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,14]]},"references-count":32,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1002\/lary.28929"],"URL":"https:\/\/doi.org\/10.1002\/lary.28929","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,14]]},"assertion":[{"value":"2020-04-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}